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A Vancouver neurosurgeon says the diagnosis of a deadly brain cancer in Tragically Hip lead singer Gord Downie is focusing needed attention on a disease that desperately needs more research and clinical tools to improve chances of survival.

“There are some longer-term survivors, but the likelihood of living to two years after a diagnosis of glioblastoma is only about 25 per cent,” said Dr. Brian Toyota. “It seems a bit callous and cruel to say, but if there’s any silver lining to someone’s else’s dark cloud then it would be that Gord would be grateful if his celebrity is used to raise awareness that helps lead to a cure.

“But once again, we are reminded that cancer plays no favourites. It doesn’t matter who you are.”

Although his cancer is incurable, Downie, 52, has been given the green light by his doctors to go on a concert tour across Canada this summer. The tumour in his left front temporal lobe was detected in December, after Downie had a seizure in Kingston where he lives. Toyota said based on news reports, it would appear Downie has been undergoing standard treatment for glioblastoma multiforme (GBM), including surgery, radiation and chemotherapy. The disease is highly lethal because it grows silently, quickly and invasively. It becomes resistant to most chemotherapy drugs, has a tendency to recur, and is in such an intricate part of the body.

In many cases, surgeons are unable to safely remove the entire tumour, which is why many weeks of followup radiation and chemotherapy is necessary. Patients newly diagnosed with GBM who receive standard therapy have a median survival of 14 to 16 months. After relapse, median survival is typically seven to nine months. Beau Biden, the son of U.S. Vice-President Joe Biden, and U.S. senator Ted Kennedy are two high-profile individuals who died from the same type of cancer as Downie.

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Neuro-surgeon Brian Toyota.Malcolm Parry/Vancouver Sun

Toyota said Vancouver General Hospital is poised to recruit patients for a new virotherapy trial, which is also taking place at a handful of hospitals across Canada and many more in the U.S. The trial is sponsored by California-based Tocagen Inc., whose study drug uses a virus to deliver the gene therapy. At VGH, Toyota says, he expects to enrol at least one patient a month for the next two years.

“Brain tumours are extremely challenging to treat, and with 27 Canadians diagnosed each day, there is an urgent need for new therapies,” said Dr. Kevin Petrecca, an associate professor in NeuroOncology at the Brain Tumour Research Centre at McGill University’s Montreal Neurological Institute and Hospital, where the first patient in Canada was enrolled in the study.“Tocagen’s innovative approach to fighting recurrent brain cancer using cancer-selective gene therapy is the kind of cutting-edge investigational treatmentthat we want to offer patients,” he said in a press release.

The Canadian arm of the study, being co-led by Downie’s neuro-oncologist, Dr. James Perry, will look at whether patients live longer and what dose is most effective. More information can be found at www.tocagen.com/toca5.

Toyota, head of neurosurgery at the University of B.C. and at VGH, is the first and only neurosurgeon in Canada to use a robotic laser system called NeuroBlate that heats and kills cancer cells in primary or recurrent brain tumours. The system was purchased with funds from a donation to the B.C. Cancer Foundation by Eleni Skalbania, the former owner of the Wedgewood Hotel who died from lung cancer that spread to her brain. (She died before benefiting from the technology but gave the donation so patients here wouldn’t have to travel to the U.S. to get such treatment).

Toyota said the technology, which he got in December of 2014, has been used on about 15 patients, half of whom are still alive. The less-invasive system uses real time magnetic resonance imaging, so he can see the laser destroying the targeted tumour cells. Patients are usually discharged from hospital the next day. In conventional brain tumour surgery, a piece of skull bone is removed so surgeons can get to the tumour. The bone is replaced after the tumour is cut out. Patients typically stay in hospital for three or four days.

Toyota said since the $350,000 Skalbania donation for NeuroBlate procedures has been used up, the hospital is funding use of the technology on a case-by-case basis. He is now collecting data to “prove” the NeuroBlate system is clinically valuable, cost-effective, and offers better quality of life so he can make the case that it is worth funding by the provincial government on a continuing basis.

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